Proteomic Analysis of the Uterosacral Ligament in Postmenopausal Women with and without Pelvic Organ Prolapse

Background： Pelvic organ prolapse （POP） is a major health problem in adult women that involves many factors. No proteomic analysis has been conducted exclusively in POP patients. This study aimed to identify the differential expression of proteins that may be involved in POP by proteomic analysis.Methods： Samples of the uterosacral ligament （USL） were collected from five POP patients and five non-POP patients matched according to age, parity, and menopausal status and analyzed using two-dimensional electrophoresis and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry （MALDI-TOF-MS）. Quantitative real-time polymerase chain reaction （qRT-PCR） was used to verify the mRNA expression of proteins that showed differential expression in the proteomic analyses. Results： Proteins differentially expressed between POP and non-POP patients were detected. Eight proteins that were down-regulated in the POP group were identified by MALDI-TOF-MS. These proteins included electron transfer flavoprotein, apolipoprotein A-I, actin, transgelin, cofilin-1, cyclophilin A, myosin, and galectin-1, and their expression was verified by qRT-PCR. Conclusion： Using comparative proteomics, we identified eight differentially expressed proteins （including four cytoskeleton proteins and three proteins related to apoptosis） in the USL that may be involved in apoptosis associated with the tissue effects in POP pathophysiology.

Clinical analysis of laparoscopic lateral peritoneal suspension in the treatment of severe pelvic organ prolapse

Objective:To investigate the clinical effects of laparoscopic lateral peritoneal suspension for severe pelvic organ prolapse(POP).Methods:Thirty-eight patients who underwent laparoscopic lateral peritoneal suspension for pelvic organ prolapse in the gynecology department of our hospital from January 2019 to January 2020 were selected for retrospective analysis.Postoperative outcomes were recorded for patients at 3,6,and 12 months postoperatively.Results:All 38 patients completed the surgery safely,and the duration of surgery was 85-190 min,with a mean of(138±40.75)min;surgical bleeding was 30-80 ml,with a mean of(57±35.4)ml;the duration of postoperative catheterization was 4-6 days,with a mean of(5±0.73)days;postoperative hospitalization was 6-12 days,with a mean of(8.49±2.18)days.2.18)days.At 3,6,and 12 months after the end of surgery,all follow-up patients had their uterus and anterior vaginal wall restored to normal position without prolapse.The pelvic floor rehabilitation of the patients after surgery was good and their sexual life was significantly improved in all cases.Conclusion:Laparoscopic lateral peritoneal suspension for severe pelvic organ prolapse is safe,efficacious,minimally traumatic,less painful,with short hospital stay,fast postoperative recovery,greater choice of uterine de-positioning,with the advantages of permanence and good pelvic floor anatomical recovery,and this procedure can maintain a certain vaginal length with 100%efficiency,which is worthy of clinical promotion.

Characteristics of pathological findings in women with chronic pelvic pain using conscious mini-laparoscopic pain mapping

Chronic pelvic pain （CPP） is a common and disabling disorder of women that may have a significant impact on a woman＇s personal health and quality of life.Data have shown an annual prevalence of 3.8% in women 15 to 73 years of age, making its prevalence comparable to that of asthma （3.7%）, back pain （4.1%）, and migraines （2.1%）. CPP in women is described as ＂intermittent or constant pain in the lower abdomen or pelvis of at least six months duration, not occurring exclusively with menstruation or intercourse and not associated with pregnancy＂. In addition, the condition is considered as a symptom, not a diagnosis. CPP is estimated to account for 10% of all referrals to gynecologists, 12% of all hysterectomies, and more than 40% of gynecologic diagnostic laparoscopies. The etiology is complex and may involve disorders of the reproductive tract,gastrointestinal tract, urinary tract, musculoskeletal system, and psychoneurological system. The diagnosis is often difficult, especially when nothing positive is found on physical examimation and imaging studies. The optimal management is usually difficult due to the unknown etiology.